PDF(Pubmed)
Abstract：
UNASSIGNED: To assess the feasibility of repeated sperm recovery in patients with non-obstructive azoospermia (NOA), as little is known about the extraction rate in repeated microdissection testicular sperm extraction (microTESE) in these patients.
UNASSIGNED: A total of 134 men with NOA had their first sperm recovery between January 2013 and February 2020. Repeated microTESE had been done mostly for patients with a successful initial retrieval.
UNASSIGNED: In the 323 procedures performed on the 134 men with NOA, sperm could be retrieved in 236 procedures (73.1%). A total of 88, 61 and 40 men underwent two, three and four sperm retrievals, respectively. In these cycles, sperm could be extracted in 65 (73.9%), 53 (86.9%) and 37 (92.5%) men, respectively. During the first microTESE procedure, sperm could be extracted in 81 (60.4%) men with NOA. In all, the success rate was significantly different between subgroups, showing highest rate in hypospermatogenesis cases (95.6%), followed by maturation arrest (58.5%), and Sertoli cell-only syndrome (56.0%). However, this difference was not significant at the third and fourth repeated microTESE. The FSH levels and testicular volume were among the noticeable factors affecting success of sperm retrieval. The duration between the first and second biopsies significantly increased the success rate by a factor of 1.3-fold/month; however, afterwards, the duration did not play any role in the success of microTESE. The success of previous trial significantly increased the probability of success by 10.1-fold in the second trial, 5.6-fold in the third trial, and 16.5 folds in the fourth.
UNASSIGNED: Repeated MD -TESE ensures a high sperm recovery rate in patients with NOA. These data also show that when no spermatozoa can be obtained after thawing cryopreserved testicular sperm for ICSI in NOA patients, a repeat microTESE procedure can be planned.
UNASSIGNED: ICSI: intracytoplasmic sperm injection; IVF: in vitro fertilisation; MA: maturation arrest; (N)OA: (non-)obstructive azoospermia; OR: odds ratio; SCOS, Sertoli cell-only syndrome; SRR: spermatozoa retrieval rate; (micro)TESE: (microdissection) testicular sperm extraction.
UNASSIGNED: A total of 134 men with NOA had their first sperm recovery between January 2013 and February 2020. Repeated microTESE had been done mostly for patients with a successful initial retrieval.
UNASSIGNED: In the 323 procedures performed on the 134 men with NOA, sperm could be retrieved in 236 procedures (73.1%). A total of 88, 61 and 40 men underwent two, three and four sperm retrievals, respectively. In these cycles, sperm could be extracted in 65 (73.9%), 53 (86.9%) and 37 (92.5%) men, respectively. During the first microTESE procedure, sperm could be extracted in 81 (60.4%) men with NOA. In all, the success rate was significantly different between subgroups, showing highest rate in hypospermatogenesis cases (95.6%), followed by maturation arrest (58.5%), and Sertoli cell-only syndrome (56.0%). However, this difference was not significant at the third and fourth repeated microTESE. The FSH levels and testicular volume were among the noticeable factors affecting success of sperm retrieval. The duration between the first and second biopsies significantly increased the success rate by a factor of 1.3-fold/month; however, afterwards, the duration did not play any role in the success of microTESE. The success of previous trial significantly increased the probability of success by 10.1-fold in the second trial, 5.6-fold in the third trial, and 16.5 folds in the fourth.
UNASSIGNED: Repeated MD -TESE ensures a high sperm recovery rate in patients with NOA. These data also show that when no spermatozoa can be obtained after thawing cryopreserved testicular sperm for ICSI in NOA patients, a repeat microTESE procedure can be planned.
UNASSIGNED: ICSI: intracytoplasmic sperm injection; IVF: in vitro fertilisation; MA: maturation arrest; (N)OA: (non-)obstructive azoospermia; OR: odds ratio; SCOS, Sertoli cell-only syndrome; SRR: spermatozoa retrieval rate; (micro)TESE: (microdissection) testicular sperm extraction.
摘要：
■为了评估非梗阻性无精子症（NOA）患者重复精子回收的可行性，由于对这些患者重复显微切割睾丸精子提取（microTESE）的提取率知之甚少。
■在2013年1月至2020年2月期间，共有134名患有NOA的男性进行了首次精子恢复。重复的microTESE主要是针对初次检索成功的患者。
■在对134名患有NOA的男性进行的323次手术中，在236个程序中可以回收精子(73.1%)。共有88人、61人和40人经历了两次，三个和四个精子回收，分别。在这些周期中,精子可以在65（73.9%）中提取，53（86.9％）和37（92.5％）男性，分别。在第一次microTESE手术中，81名(60.4%)NOA男性可以提取精子。总之,亚组之间的成功率有显著差异，在精子发生不足病例中发病率最高(95.6%)，其次是成熟逮捕(58.5%)，和仅支持细胞综合征（56.0％）。然而,在第3次和第4次重复的microTESE中,这种差异并不显著.FSH水平和睾丸体积是影响精子回收成功的重要因素。第一次和第二次活检之间的持续时间显着增加了1.3倍/月的成功率;然而，之后,持续时间对microTESE的成功没有任何作用.先前试验的成功使第二次试验的成功概率显著增加了10.1倍，在第三次审判中增加了5.6倍，第四层16.5折.
■重复MD-TESE可确保NOA患者的高精子回收率。这些数据还表明，在NOA患者中，当冷冻保存的睾丸精子解冻后无法获得用于ICSI的精子时，可以计划重复microTESE程序。
■ICSI：卵胞浆内单精子注射；IVF：体外受精；MA：成熟停滞；（N）OA：（非）阻塞性无精子症；OR：比值比；SCOS，仅支持细胞综合征；SRR：精子提取率；（显微）TESE：（显微解剖）睾丸精子提取。
■在2013年1月至2020年2月期间，共有134名患有NOA的男性进行了首次精子恢复。重复的microTESE主要是针对初次检索成功的患者。
■在对134名患有NOA的男性进行的323次手术中，在236个程序中可以回收精子(73.1%)。共有88人、61人和40人经历了两次，三个和四个精子回收，分别。在这些周期中,精子可以在65（73.9%）中提取，53（86.9％）和37（92.5％）男性，分别。在第一次microTESE手术中，81名(60.4%)NOA男性可以提取精子。总之,亚组之间的成功率有显著差异，在精子发生不足病例中发病率最高(95.6%)，其次是成熟逮捕(58.5%)，和仅支持细胞综合征（56.0％）。然而,在第3次和第4次重复的microTESE中,这种差异并不显著.FSH水平和睾丸体积是影响精子回收成功的重要因素。第一次和第二次活检之间的持续时间显着增加了1.3倍/月的成功率;然而，之后,持续时间对microTESE的成功没有任何作用.先前试验的成功使第二次试验的成功概率显著增加了10.1倍，在第三次审判中增加了5.6倍，第四层16.5折.
■重复MD-TESE可确保NOA患者的高精子回收率。这些数据还表明，在NOA患者中，当冷冻保存的睾丸精子解冻后无法获得用于ICSI的精子时，可以计划重复microTESE程序。
■ICSI：卵胞浆内单精子注射；IVF：体外受精；MA：成熟停滞；（N）OA：（非）阻塞性无精子症；OR：比值比；SCOS，仅支持细胞综合征；SRR：精子提取率；（显微）TESE：（显微解剖）睾丸精子提取。
